Publications by authors named "Ngonzi Joseph"

Background: The healthcare workforce is one of the six core components of a well-functioning and sufficient health system. The WHO highlights that improving education and training of the health workforce is critical to improving health systems. Medical education is a pillar of the healthcare workforce.

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  • A study at Mbarara Regional Referral Hospital investigated the prevalence of bacterial colonization in the amniotic fluid of women with premature rupture of membranes (PROM) and its potential impact on health outcomes.
  • Researchers enrolled 144 women and found a 35.4% prevalence of bacterial colonization, with significant isolates and notable antibiotic resistance patterns identified, including high sensitivity to ciprofloxacin.
  • Factors linked to bacterial colonization included being a first-time mother (prime gravidity), obesity, and having been referred from another facility.
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Objective: Non-communicable diseases (NCDs) increasingly contribute to maternal morbidity and mortality. We determined the association between NCDs and obstetric complications at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda.

Methods: In this retrospective records review, we randomly selected records of women admitted for delivery at MRRH each month from January to December 2022, and extracted their socio-demographic and clinical histories.

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Background: Artemisinin-based combination therapy (ACT) is currently recommended for treatment of uncomplicated malaria. However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (pfk13 mutations) in Plasmodium falciparum is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.

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Background: Babies born via caesarean section in low-income settings face a higher risk of early-onset neonatal sepsis (EONS), which has greater mortality than late-onset sepsis. However, maternal factors contributing to EONS among caesarean-delivered babies in these settings, including Uganda, are not well documented. We determined maternal factors associated with EONS among term babies delivered by caesarian section at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda.

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  • * A study at MRRH from December 2022 to May 2023 evaluated 128 women with HDP, revealing that 52.3% had abnormal CPR, particularly those suffering from severe pre-eclampsia and eclampsia, which were linked to a higher risk of abnormal CPR.
  • * The study suggests that obstetric Doppler studies evaluating CPR should be
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Background: The risk of infection following cesarean delivery is 5-20 times higher than that following normal delivery, contributing to 10% of pregnancy-related mortality. In 2019, Mbarara Regional Referral Hospital (MRRH) performed cesarean section for 40% of deliveries, surpassing the WHO's recommended 15%-20%. The availability and provision of effective prophylactic antibiotics are crucial in preventing surgical site infections (SSIs).

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  • HELLP syndrome is a serious health issue for pregnant women that can happen with conditions like preeclampsia, especially in places like Uganda where hospitals might not have all the necessary tests.
  • A study at Mbarara Regional Referral Hospital found that about 19% of pregnant women with preeclampsia or eclampsia had HELLP syndrome.
  • Younger mothers, those with stomach pain, and those coming from smaller health facilities were more likely to have HELLP syndrome.
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Background: Obstructed labour, a sequel of prolonged labour, remains a significant contributor to maternal and perinatal deaths in low- and middle-income countries.

Objective: We evaluated the modified World Health Organization (WHO) Labour Care Guide (LCG) in detecting prolonged and or obstructed labour, and other delivery outcomes compared with a traditional partograph at publicly-funded maternity centers of rural Mbarara district and City, Southwestern Uganda.

Methods: Since November 2023, we deployed the LCG for use in monitoring labour by trained healthcare providers across all maternity centers in Mbarara district/City.

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Introduction: Each year, millions of teenagers in low-resource areas experience unintended pregnancies, many of which result in childbirth. These pregnancies often carry an increased risk of negative perinatal outcomes.

Objectives: The study determined the prevalence and factors associated with adverse perinatal outcomes among teenagers delivering at a tertiary referral hospital in southwestern Uganda.

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Postpartum sepsis following caesarean sections among women in Uganda remains a risk. However, erratic supplies of standard dressing material make the risk a reality. Alternative wound dressing materials, therefore, remain a viable option.

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Background: Deaths occurring during the neonatal period contribute close to half of under-five mortality rate (U5MR); over 80% of these deaths occur in low- and middle-income countries (LMICs). Poor maternal antepartum and perinatal health predisposes newborns to low birth weight (LBW), birth asphyxia, and infections which increase the newborn's risk of death.

Methods: The objective of the study was to assess the association between abnormal postpartum maternal temperature and early infant outcomes, specifically illness requiring hospitalisation or leading to death between birth and six weeks' age.

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Biomarkers including Forkhead/winged-helix transcription factor box P3 have been proposed in immunohistochemical techniques to diagnose cervical lesions, but can be objectively quantified and measured in blood using methods that can be standardised. In this study we quantified the serum FOXP3 concentrations and assessed their association with cervical lesions at the cervical cancer clinic of Mbarara Regional Hospital (MRRH) Southwestern Uganda. We performed secondary analysis on archived serum samples from a previous unmatched case control study in which we recruited 90 cervical cancer (CC) cases, 90 cervical intraepithelial neoplasia (CIN) cases before any form of treatment and 90 controls.

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Objective: To determine the association between MetS and its components with cervical cancer among women in South-western Uganda.

Methods: We conducted an unmatched case-control study on 470 participants in a 1:2 case-to-control ratio among women in southwestern Uganda. We recruited 157 women with cervical cancer as cases and 313 women without cervical cancer as controls at the Mbarara Regional Referral Hospital Cervical Cancer Clinic.

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Background: Altered lipid levels may be associated with the development of a number of malignancies, including cancer of the cervix. However, there is limited understanding of this relationship in the rural Ugandan context.

Objective: We investigated the connection between dyslipidaemias and cervical intraepithelial neoplasia (CIN) among women attending the cervical cancer clinic at Mbarara Regional Referral Hospital in south-western Uganda.

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Sub-Saharan Africa accounts for two-thirds of the global burden of maternal and newborn deaths. Adverse outcomes among postpartum women and newborns occurring in the first six weeks of life are often related, though data co-examining patients are limited. This study is an exploratory analysis describing the epidemiology of postnatal complications among postpartum women and newborns following facility birth and discharge in Mbarara, Uganda.

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Introduction: Many female teenagers in low-resource settings conceive, of which half are unplanned and end in many deaths in sub-Saharan Africa, accounting for the majority of the cases. Teenage pregnancy is associated sometimes with poor maternal, newborn, and child deaths.

Objectives:  The aim of the study was to determine the prevalence, maternal obstetric outcomes, and factors associated with poor maternal obstetric outcomes among teenage mothers delivering at Mbarara Regional Referral Hospital.

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Background: Early implant removal not only results in method wastage and strains healthcare resources but also exposes women to the risk of unplanned pregnancies and associated complications if an alternative contraceptive is not promptly adopted. Studies have demonstrated that prevalence and factors associated with contraceptive use vary across different cultures and regions even within Uganda. We determined the prevalence and associated factors of early implant removal, among women attending public family planning clinics in Mbarara City, southwestern Uganda.

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Background The stage of disease at diagnosis is one of the major determinants of survival in women with cervical cancer. Most women with cervical cancer in low- and middle-income countries (LMICs) present to hospitals with advanced stages, thus reducing their survivorship following the diagnosis. Factors correlated with late-stage disease at diagnosis are not completely explored.

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Despite the global implementation of preventive strategies against Human Papilloma Virus (HPV) infection, the incidence of invasive cervical cancer rose by nearly 1.3-fold, from 471,000 annual cases in 2000 to 604,000 cases in 2020. With over 340,000 deaths annually, cervical cancer is the fourth leading cause of cancer mortality in women globally.

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Background: Cervical cancer screening uptake remains low despite being a critical prevention method for adult women living with HIV(WLHIV). These women experience greater incidence and persistence of high-risk human papillomavirus (HPV) and severe outcomes, including cervical cancer comorbidity and death.

Objective: We explored the opportunities, challenges, and recommendations of clinical care providers and WLHIV to improve cervical cancer screening uptake among WLHIV in Southwestern Uganda.

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  • A qualitative study in southwestern Uganda explored the experiences of teenage mothers delivering at a tertiary referral hospital, focusing on the unique physical and psychological challenges they face.
  • The study involved 32 participants, mostly rural, married, and unemployed, who shared feelings of shattered dreams, concerns about body image, abandonment, forced early marriages, and engaging in sex for survival.
  • Results highlighted that despite significant challenges, the teenage mothers showed resilience with support from loved ones, underscoring the need for further research to create culturally relevant strategies to address teenage pregnancy and enhance maternal outcomes.
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Studies suggest a need for new diagnostic approaches for cervical cancer including microRNA technology. In this review, we assessed the diagnostic accuracy of microRNAs in detecting cervical cancer and Cervical Intraepithelial Neoplasia (CIN). We performed a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline for protocols (PRISMA-P).

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  • * A total of 364 women participated, with an average age of 41.9 years; results showed that 6.6% had cervical intraepithelial lesions, primarily low-grade, and a significant number were using hormonal contraceptives.
  • * Key findings indicated that the use of hormonal contraceptives, intrauterine devices, and a family history of cervical cancer were significantly linked to the presence of these lesions, suggesting factors that could be addressed for prevention and early
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